Basic Information
| Provider Information | |||||||||
| NPI: | 1427071612 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | FLIPPO | ||||||||
| FirstName: | KORIE | ||||||||
| MiddleName: | LEIGH | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 911230 | ||||||||
| Address2: | |||||||||
| City: | DALLAS | ||||||||
| State: | TX | ||||||||
| PostalCode: | 753911230 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9729978000 | ||||||||
| FaxNumber: | 9722340813 | ||||||||
| Practice Location | |||||||||
| Address1: | 4708 ALLIANCE BLVD | ||||||||
| Address2: | SUITE 150 | ||||||||
| City: | PLANO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 750935340 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9725967801 | ||||||||
| FaxNumber: | 9725969307 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/26/2006 | ||||||||
| LastUpdateDate: | 06/12/2015 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | L6380 | TX | N | Allopathic & Osteopathic Physicians | Internal Medicine | 208M00000X | L6380 | TX | N | Allopathic & Osteopathic Physicians | Hospitalist | 207RX0202X | L6380 | TX | N | Allopathic & Osteopathic Physicians | Internal Medicine | Medical Oncology | 207RH0003X | L6380 | TN | N | Allopathic & Osteopathic Physicians | Internal Medicine | Hematology & Oncology | 207RH0003X | L6380 | TX | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Hematology & Oncology |
ID Information
| ID | Type | State | Issuer | Description | 159227101 | 05 | TX | MEDICAID | 159227102 | 05 | TX | MEDICAID | P01259259 | 01 | TX | RAILROAD MEDICARE | OTHER | 159227104 | 05 | TX | MEDICAID | 159227105 | 05 | TX | MEDICAID | 8DX189 | 01 | TX | BCBS OF TEXAS | OTHER | 8S3592 | 01 | TX | BCBS | OTHER |